No More ‘Sit Bone' Pain

Elise is sixty. As she sits in the chair opposite me I get the sense that she is tensed and anxious. This lady was careful to put down a buttock support in the chair but was struggling to find just the right angle for sitting in it.

- Dr Joseph Kellerstein

According to the intake form she is complaining of chronic muscle pain and anxiety. She is currently taking Lorazepam and Cymbalta. There is a history of recent hip fracture and repair. Her first menses were at 15 years of age. Her chief complaint comes from her ‘sit bones.’ There is pain from just under the sit bones. It is worse sitting and can extend to the lower back. This began in the summer of 2010. The pain is worse going up and down stairs. It also gets worse from stooping.

Just as an interesting aside, Elise mentions that she did notice that when she allowed herself to just cry the tears afforded some good relief. However, since her diagnosis with depression and subsequent medication, the tears have dried up, so this outlet is no longer the case.

There is as well soreness in both shoulder joints extending into the pectoral area, just under the clavicle and then to the upper arms. The pains are of more recent onset and are there since the hip fracture where she had to ‘hoist herself around.’

By 4:30pm, every day, the pain becomes intense and Elise must lie down. By then there are tears. It necessitates Lorazepam.

The lower back hurts from having to stoop. The shoulders hurt from lifting. “I live with the pain all day. It becomes overwhelming. When I go into the kitchen and think about preparing a meal, it just takes over.”

The next complaint is hot flushes. “If I get a hot flush I get an electric charge, as if an electric current were running through my body.” It starts at the feet and ascends.

Further questioning yielded a history of emotional distress related to her work environment. Elise felt socially isolated there. There was conflict with a fellow employee. Just knowing there was conflict in the room and the proximity was too much. Soon, she was ready for a change and left. The anxiety takes its origin here.